毛细支气管炎患儿血清中MIP-1α、ECP水平及临床意义

发布时间：2018-03-12 20:41

本文选题：毛细支气管炎　切入点：儿童　出处：《吉林大学》2012年硕士论文　论文类型：学位论文

【摘要】：研究背景：毛细支气管炎是2岁以下婴幼儿特有的呼吸系统疾病，主要由呼吸道合胞病毒感染引起。临床上主要表现为咳嗽、呼吸困难及喘憋，严重者可合并呼吸衰竭、心力衰竭等，严重威胁患儿的生命。目前对本病尚无有效的治疗方法，以对症支持治疗为主。毛细支气管炎的发病机制十分复杂，多种免疫细胞及免疫分子参与其发病过程。MIP-1α是CC趋化因子家族即β趋化因子家族，主要趋化CD4+T细胞、CD8+T细胞、单核细胞、嗜酸性粒细胞、肥大细胞、嗜碱性粒细胞等浸润，并能增强其活性，激活的免疫细胞释放多种炎性介质，破坏气道上皮细胞。此外，MIP-1α还能诱导嗜酸性粒细胞释放ECP，刺激肥大细胞、嗜碱性粒细胞释放组胺。ECP是嗜酸性粒细胞活化后释放的一种碱性蛋白，是嗜酸性粒细胞活化的标志。ECP能诱导肥大细胞释放组胺，并且能直接损伤呼吸道上皮细胞，导致细胞脱落，引起气道高反应。国内外对于MIP-1α在毛细支气管炎中的作用方面研究比较少,而对于急性期毛细支气管炎血清中ECP水平是否升高，目前尚存在争议。为此，我们对毛细支气管炎患儿血清中MIP-1α及ECP的水平进行检测。研究目的：探讨毛细支气管炎患儿血清中MIP-1α、ECP的水平及临床意义，并分析急性期MIP-1α、ECP水平的高低与患儿日后喘息的关系。研究方法：本实验选取2010年11月至2011年12月在吉林大学第一医院小儿呼吸科明确诊断为毛细支气管炎的患儿为研究对象，同时选取同期因睾丸鞘膜积液、腹股沟斜疝、脐疝入住我院小儿外科无感染性疾病的患儿作为对照组。采用双抗体夹心酶联免疫吸附法（ELISA）测定毛细支气管炎患儿急性期、恢复期及对照组血清中MIP-1α、ECP水平。毛细支气管炎患儿治愈后随访6~12个月，，观察有无喘息发作。所有数据应用SPSS17.0软件进行统计学分析。研究结果： 1.毛细支气管炎患儿急性期血清中MIP-1α、ECP水平高于恢复期和对照组，差异有统计学意义（P＜0.01）； 2.毛细支气管炎患儿恢复期血清中MIP-1α、ECP水平仍高于对照组，差异有统计学意义（P＜0.05）； 3.毛细支气管炎治愈后再次发生喘息的患儿急性期血清中MIP-1α、ECP水平高于未再发生喘息的患儿，差异有统计学意义（P＜0.05）； 4.毛细支气管炎患儿急性期血清中MIP-1α与ECP呈正相关，r=0.646，P＜0.01。结论： 1.毛细支气管炎患儿急性期血清中MIP-1α、ECP水平高于对照组，恢复期血清中两者水平较急性期下降，但仍高于对照组，提示MIP-1α、ECP可能在毛细支气管炎发病中发挥一定作用； 2.毛细支气管炎患儿急性期血清中MIP-1α、ECP水平越高，毛细支气管炎治愈后发生喘息的可能性越大； 3.毛细支气管炎患儿急性期血清中MIP-1α与ECP水平呈正相关。
[Abstract]:Background: bronchiolitis is a special respiratory disease in infants under 2 years of age. It is mainly caused by respiratory syncytial virus infection. Heart failure and other serious threats to the life of children. There is no effective treatment for this disease, mainly for symptomatic support treatment. The pathogenesis of bronchiolitis is very complex. Many kinds of immune cells and immunomolecules participate in its pathogenesis. MIP-1 伪 is a family of CC chemokines, that is, 尾 chemokines, mainly chemotaxis of CD4 T cells, monocytes, eosinophils, mast cells, basophil, and so on, and mainly chemotaxis of CD8 T cells, monocytes, eosinophils, basic granulocytes, and so on. In addition, MIP-1 伪 can also induce eosinophils to release ECPs and stimulate mast cells. Eosinophil releasing histamine. ECP is a basic protein released after eosinophil activation. ECP can induce mast cells to release histamine and directly damage respiratory epithelial cells. There are few studies on the role of MIP-1 伪 in bronchiolitis at home and abroad, but it is still controversial whether the level of ECP in serum of acute bronchiolitis is elevated. The levels of MIP-1 伪 and ECP in serum of children with bronchiolitis were determined. Objective: to investigate the level and clinical significance of MIP-1 伪 in the serum of children with bronchiolitis, and to analyze the relationship between the level of MIP-1 伪 and wheezing in children with bronchiolitis. Research methods:. From November 2010 to December 2011, children who were diagnosed as bronchiolitis in the Department of Pediatric ventilation, first Hospital of Jilin University, were selected as subjects. Meanwhile, indirect inguinal hernia due to testicular hydrocele was selected. Umbilical hernia children admitted to our hospital as control group were examined for the acute phase of bronchiolitis by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). The serum levels of MIP-1 伪 in the convalescent group and the control group were followed up for 612 months after the recovery of bronchiolitis. All the data were analyzed statistically by SPSS17.0 software. Results of the study:. 1. The levels of MIP-1 伪 in acute bronchitis were significantly higher than those in convalescent and control groups (P < 0.01). 2. The serum level of MIP-1 伪 in children with bronchiolitis was still higher than that in the control group (P < 0.05). 3. The level of MIP-1 伪 in the serum of the children with bronchiolitis was higher than that of the children without asthma in the acute phase, and the difference was statistically significant (P < 0.05). 4. There was a positive correlation between serum MIP-1 伪 and ECP in children with bronchiolitis at acute stage (P < 0.01). Conclusion:. 1. The levels of MIP-1 伪 in the acute phase of bronchiolitis were higher than those in the control group, and the levels of both in the convalescent phase were lower than those in the acute phase, but still higher than those in the control group, suggesting that MIP-1 伪 may play a role in the pathogenesis of bronchiolitis. 2. The higher the level of MIP-1 伪 in the serum of children with bronchiolitis, the greater the possibility of wheezing after bronchiolitis was cured. 3. There was a positive correlation between serum MIP-1 伪 and ECP levels in children with bronchiolitis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6

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